| Objective: To explore HAS-BLED score,CRUSADE score for unstable angina(UA),non-ST-stageelevated myocardial infarction(NSTEMI),and ST-stage elevated myocardial infarction(STEMI)patients who received DAPT after undergoing coronary artery intervention therapy(PCI).The predicted value of upper gastrointestinal bleeding events within 1 year of treatment.Methods: Retrospective analysis of atotal of 811 ACS patients in the cardiovascular medicine ward of Shengjing Hospital,affiliated with China Medical University,from August 2018 to October2019,of which 432 were UA patients and 200 were NSTEMI patients,179 were STEMI patients,all of which received PCI and regular DAPT,calculated HAS-BLED scores,CRUSADE scores per patient,and performed statistical analysis using SPSS and Medcalc software.Evaluate the predicted value of both scores for upper gastrointestinal bleeding 1 year after PCI.Results:(1)7 people had gastrointestinal bleeding in UA group 、 6 people had gastrointestinal bleeding in NSTEMI group、7 people had gastrointestinal bleeding in STEMI group,Upper gastrointestinal bleeding rate was 1.62%,3% and 3.91%,respectively,after the card side test,three groups of patients on the digestive tract bleeding rate no difference(P>0.05)。(2)811 ACS patients,a total of 20 events occurred in the upper digestive tract total and 791 patients without bleeding。People The proportion of female patients in the bleeding group,the average age,the proportion of patients with liver and renal insemination,the proportion of patients with heart failure,and the proportion of patients with a history of hemorrhage were higher than that of the non-bleeding group(P<0.05)。The weight,BMI,creatinine removal rate,red blood cell build-up,and the proportion of patients using PPI drugs in the bleeding group were lower than in the non-bleeding group(P<0.05)。 There was no difference between the two groups of patients in height,systolic pressure,heart rate,stroke history,diabetes history,history of exovascular disease,history of alcoholism,and the proportion of patients with heparin in hospital(P>0.05)。(3)In UA Group 、NSTEMI Group、STEMI group、 or the whole group,according to HAS-BLED、CRUSADE Scoring risk strat layering,calculating the probability of upper gastrointestinal bleeding events under different risk stratums,tested by the card side,in three groups of patients,the above two scores with the increase of risk strat layering,upper gastrointestinal bleeding rate increased,the difference is statistically significant(P < 0.05(4)Pass Subjects work(ROCThe area under the curve(AUC),assessment HAS-BLED、CRUSADEThe score was of predicted value for upper gastrointestinal bleeding in patients in the UAGroup HAS-BLED Score AUC is 0.875(P < 0.001),CRUSADE Score AUC is 0.797(P=0.005)。In NSTEMI Group HAS-BLED Score AUC is 0.777(P<0.001),CRUSADE Score AUC is 0.869(P<0.001)。In STEMI Group HAS-BLED Score AUC is 0.878(P<0.001),CRUSADE Score AUC is 0.887(P<0.001)。In ACS group,HAS-BLED Score AUC is 0.839(P<0.001),CRUSADE Score AUC is 0.859(P<0.001)。In each group of patients,further use Delong Inspection Compare the two scoring subjects’ work characteristic curves(ROCLower area(AUC),the difference is not statistically significant(P>0.05)。Conclusion: Whether in UA,NSTEMI,STEMI,or the whole group of ACS patients,CRUSADE score and HAS-BLED score showed good predictive ability for upper gastrointestinal bleeding events during the 1 year of DAPT after PCI,and both showed comparable predictive abilities. |
